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Excimer Lasers - Aren't they all the same? Many people believe "a laser is a laser is a laser." It's understandable, given that all LASIK systems use a laser beam to reshape corneas and help correct vision problems. But there are many differences in LASIK equipment.
- The Allegretto uses a small-spot Gaussian beam and follows eye movement with a closed-loop eye tracker. It has a true optic treatment zone up to 8mm.
- The VisX uses a broad beam and a video open-loop tracker. It has a true optic treatment zone up to 6.5mm.
Why Tracking Matters The first, and perhaps most important, difference in lasers is the eye tracker. It tracks your eye movements so that even when your eye moves during surgery -and it will- the laser beam still makes precise contact with the cornea in exactly the right spot. You may never be aware of it, but everyone's eyes move about 100 times a second. These involuntary movements, called saccadic movements, can interfere with the placement and accuracy of the laser beam. So a tracker has to be fast enough to register these movements, and it has to track them continuously. Tracker speeds range from 60 times per second to more than 4,000 times per second, depending on the type of tracker. If the tracker is at least as fast as the eye's movement, the likelihood is greater that the laser beam will focus precisely on the area targeted for correction.
Trackers employ open-loop vs. closed-loop technologies. Open loop video systems like the VisX follow eye drift, but shut the laser off if the eye moves beyond limits set by the doctor. No video tracker is FDA approved to improve the accuracy of the laser during surgery. A closed-loop system like the Allegretto actually measures and compensates for eye movements. By locking-on to the eye, and staying locked on for the duration of the surgery, the laser can accurately predict where the eye will be at the exact moment the laser beam makes contact.
Why the Laser Beam Matters The second important thing to consider is the kind of laser beam used. They're really not all the same. Laser beams can range from 9mm to less than 1mm in width. It's the width of the beam that defines it as either a broad-beam or small-spot beam laser. Like a wide paintbrush, broad-beam lasers can cover a large amount of surface quickly but may not be precise and gradual in the shaping of the cornea. A small-spot beam, on the other hand, is less than 1mm in width and lets the surgeon do corneal shaping in fine, gradual, precise increments.
Why the Optic Treatment Zone Matters The third important thing to look for is the true optic treatment zone of the laser. The optic zone should match or exceed your pupil size in dim illumination so that at night, when your pupils expand, you still see through a fully corrected cornea. This will minimize any chance of glare, halos or starbursts at night. Don't be misled by "blend zones." These are transition areas that gradually smooth out the edges of the laser treatment area to minimize night vision problems. But blend zones don't enlarge the actual optic treatment zone. Make sure your pupil size is measured in low light and choose a laser with an optic zone that meets or exceeds that measurement.
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